In the last several weeks I have performed a number of breast augmentation revisions surgeries. Breast augmentation revision is usually a combination of implanting smaller breast implants and then performing a breast lift. Interestingly enough, each one of these women were seeing me for the same issue. These were all petite women who had breast augmentation performed by another plastic surgeon. All of these breast augmentation cases were done with large saline breast implants. They were uncomfortable and felt that they looked too big. I agreed with all of them that they did look too big. And I’ve blogged about Heidi Montag and her choice of breast implants before and of course about Sheyla Hershey and the removal of her “world’s largest breast implants.” So before I go on let me recap my objections to large saline implants in small framed women.
1. The breast implants look disproportionate and make the patient look unbalanced.
2. Large implants in small women make them look fat in their clothes and top-heavy.
3. Large saline breast implants create more fitting of the skin and more wrinkling and rippling.
4. Large saline breast implants cause more dissent of the implant overtime and therefore more sagging.
5. Large saline breast implants because of the thinning of the skin feel like a waterbed.
It is true that some of these changes could happen with large silicone breast implants of equivalent size, however, they are more pronounced with saline breast implants.
To solve this issue and create a more balanced look for each of these women, I removed the larger implants replaced them with an appropriate sized silicone breast implant and then designed the breast lift over this new implant. As I’ve written before, you can make preliminary markings before the surgery but the actual proof is in the operating room. With the new breast implants in place, temporary sutures are placed on the outside of the skin without any incisions and the breast is tailor tacked to the appropriate shape. This process may take several tries until we are able to achieve the ideal shape. At that point, the extra skin is removed and the breast is tightened and lifted.
Breast revisions are never an easy operation but they are very satisfying one for both the patient and the doctor. The difference in comfort, aesthetics, and self-image are amazing. Every single patient that I have converted from saline to silicone implants has commented on how much better they feel. The average breast implant should last 20 to 30 years but if you have a result that you are not happy with, there is no reason to wait that long to change it.
Of course, the best option would have been to choose the right size breast implant from the very beginning. This is why I discuss the downside of choosing breast implants that are too large in the first place and then I don’t have to worry about the patient coming back in because they are unhappy with their results!
